Friday, October 6, 2017

Explaining Addiction in the Wake of the Opioid Crisis

Ted Crawford, Clinical Therapist

“Addiction” is a topic forever on the list of issues associated with pain, death and the general destruction of society’s fabric. This, especially with recent reports that we are experiencing an opioid crisis with approximately 2 million people addicted to painkillers derived from opium or formulated to replicate the pain-reducing properties of opium. However, most of the population would have difficulty accurately defining addiction or discussing how it operates. So, for clarity’s sake, know that we have special chemicals that naturally flow in our brain as we feel pleasure. Theoretically, anything that gets these “feel good juices” flowing can be abused or develop into an addiction, especially those that tend to give us the more powerful boosts: alcohol and drugs, sex, eating, gambling, shopping, the internet, chasing power and money, etc.

Physiologically, addiction is a brain disorder. A pebble-sized structure in the midbrain called the amygdala controls our survival response. Think of it as your “Emergency Management Director.” When a crisis activates it, it nudges logic and reasoning over a bit and takes the wheel, which is preferable when you need to act quickly and don’t have time to think about whether or not insurance covers the toe you just removed with the mower. It has its flaws, however. After a period of over-indulging in a chosen chemical or activity, the amygdala becomes accustomed to the pleasure associated with it. It begins to see it as a normal part of basic functioning, and, in turn, the absence of it as an emergency. The rational brain knows there’s no real emergency, but remember it doesn’t have much say-so when we’re craving. So the compulsion to “survive” takes priority and the person does whatever’s necessary in order to use, often at a great cost. So, who becomes an addict? Best indications are: anyone with the genetics for it that over-indulges over a period of time … just like diabetes is likely to onset in a genetically predisposed person with a sedentary lifestyle and a junk-food diet.

Let’s define some terms: Abuse is any use that results in negative consequences such as (difficulties with relationships, work, health, the law, etc.). Addiction is a progressive illness that inhibits a person’s ability to moderate or quit even in the face of ongoing negative consequences (without special intervention and support that is). Addicts haven’t cornered the market on creating chaos, however. Abusers can also make bad decisions, but without those nasty genes, abusers generally have the ability to moderate or quit altogether when they’ve had a snoot-full of their own behavior.

The fact that some people can safely partake in certain pleasures and others can’t seems unfair, but it’s also unfair that a diabetic has to watch others enjoy the brownies. Seeing addiction for what it is allows people to drop their ideas that it’s about weakness or immorality. It’s a disease resulting in self-destructive behaviors that can often be labeled immoral, but a disease nonetheless. Of course, anyone with any illness ultimately has the Responsibility for an addict’s recovery is no different. The initial choice to get help must be theirs …for themselves as well as the people around them.